Carolyn Rene Petrencik, FNP-C

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1070718 Issued in TX

Practice address

716 N Highway 67 Ste 2
Cedar Hill, TX 75104-2117

Phone

(972) 291-9165

NPI assigned

Feb 12, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cedar Hill Pain and Rehab, PAGroup PAC ID 1052402989, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cedar Hill Pain & Rehab, PA

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Cedar Hill, TX
  • NPI 1922148550
  Medicare reassignment Care Compare group NPD
• Expressions Pain and Rehab, P.a.

  • Physical Medicine & Rehabilitation Physician
  • Cedar Hill, TX
  • NPI 1508036963
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1194470757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3408 VISTA LAKE CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635834",
            "telephone_number": "817-919-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 N HIGHWAY 67 STE 2",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042117",
            "telephone_number": "972-291-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRENCIK",
        "first_name": "CAROLYN",
        "middle_name": "RENE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1070718",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1070718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Pena
• Perfect Time Coaching LLC
• Brooklyn Ariel Pete, LPC, LCDC-I
• Danielle Peters
• Narin Petikun, O.D.
• Danh Quoc Pham, PHARM.D
• Thao Pham
• Huong Thien Phan, M.D.
• Nha Phan
• Robert J Philips, DDS PA

• Physical Medicine & Rehabilitation Physician in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.